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Noise-induced hearing loss.

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Jesse Green. 2002. Noise-induced hearing loss.. https://doi.org/10.1542/peds.109.5.987

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Migraine is a complex disease that includes neurologic, gastrointestinal and autonomic symptoms, although headache is most common feature. In a portion of cases headache is preceded by focal neurologic symptoms termed auras. Auditory symptoms only rarely occur as part of an aura. We describe a patient whose 13-year migraine history that included the abnormal perception an oscillation of the intensity of ambient sounds (oscillucusis). During a migraine attack immediately after oscillucusis, the patient developed acute and permanent sudden deafness. Clinical and neurologic examinations revealed only profound hearing loss in her left ear. Audiometric testing confirmed the sensorineural nature of the hearing loss. The clinical aspects and physiopathology of auditory symptoms in this case and in patients with migraine is reviewed.

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OBJECTIVE: To measure and compare different parameters of tinnitus loudness obtained via matching and to investigate their associations with self-reported severity of tinnitus. METHODS: From the audiology department 18 patients with unilateral tinnitus of sensorineural origin were selected. They underwent pure-tone audiometry, and in a matching paradigm their tinnitus pitch was estimated. Loudness was assessed at tinnitus frequency and at the frequency of best hearing and both were expressed in sensation level (SL) and hearing level (HL). Moreover, minimal masking level (MML) with white noise was assessed as well as thresholds for the tinnitus tone and a comparison tone in the contralateral ear when tinnitus was masked. RESULTS: Annoyance and grading of severity were associated with measures of loudness expressed in HL, MML, and pure-tone audiometry. Loudness in SL was not associated with self-reported severity. Tinnitus loudness, matched at the frequency of best hearing instead of the tinnitus frequency, appears to be less dependent on HL, while still being associated with distress and grading of severity. CONCLUSION: Severity of tinnitus is related to hearing thresholds, and loudness in SL provides little clinically useful information.

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[Are titanium implants superior to gold implants in the tympanic cavity?].

BACKGROUND: Gold implants in reconstructive surgery of the middle ear have proved to work sufficiently: That applies to tympanic cavity conditions without signs of chronic inflammation as also to the bacterially infected middle ear. For some years titanium implants are also in the use and established as well. The biocompatibility of titanium, the clinical and the audiological results are satisfactory. When using gold-prostheses in stapes surgery however, the still unsolved problem of occasional deafness has to be considered. PATIENTS: The clinical and functional results of middle ear surgery were examined retrospectively. There was no preselection of patients. 53 patients underwent middle ear surgery with titanium prostheses, 42 patients with gold prostheses. RESULTS: Due to their material properties and due to their delicate shape titanium prostheses (PORP, TORP) can be inserted into the tympanic cavity more simply and with better fit. The audiological results of gold and titanium prostheses are comparable. The extruding rate of the gold prostheses is substantial, whereas the extruding rate of titanium is negligible. CONCLUSION: The functional results of both materials are comparable. Due to the high extruding rates of gold prostheses titanium is clearly superior.

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